Attend: A Two-Pronged Trial to Eliminate No Shows in Diagnostic Imaging at a Community-Based Hospital

Diagnostic imaging (DI) at Niagara Health, like other hospitals, experiences challenges with patients who do not attend their scheduled appointments, resulting in a "no show." Reducing no show percentages presents an opportunity to improve upon wait lists within specific modalities such as magnetic resonance imaging (MRI) and to reduce the loss of productivity for this high-demand resource.

To reduce the MRI no-show percent in DI at two community hospitals from 6.5% to 5% through patient engagement via mailed reminder letters and education at the primary care level.

Our two-pronged approach included interventions at community hospitals and at the primary care level. Reminder letters were mailed to patients with their appointment time and other pertinent information to allow for an increased number of patients reminded about appointments and a second means of reminder. At the primary care level, an information package was sent to various independent physicians for distribution to patients requiring an MRI scan, outlining benefits of showing up to the scheduled appointment to educate patients and improve attendance at DI.

The mailing letter resulted in a significant reduction from 7.1% to 6.3% in overall no shows across two community hospitals (P = .04). The true effect of the letter was likely masked by increased wait times during the study period, which correlates with increased no-show percentages. The first trial of the information pamphlet among five practices for 1 month resulted in a nonsignificant reduction of no shows from 19% to 3% (P = .125). The second trial among 19 practices for 3 months led to a significant reduction of no shows from 7.7% to 4.2% (P = .007).

Both the methods, the mailing letter and patient-information pamphlet, provide promising results in regard to reducing the no-show percentage among patients seen in DI for MRI appointments.